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Wyoming rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.89 / $282.89 / $495.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.53 / $552.53 / $552.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.53 / $552.53 / $552.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $362.03 / $612.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.27 / $264.27 / $362.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.44 / $249.43 / $384.36